The Connection Between Testosterone and Aging in Men

By Dr. Jennifer Hopkins, DNP, MHA, AGPCNP-BC
Integrative Medicine Specialist | Certified in Hormone Health
Medical Director of Mindful Medicine

Understanding Testosterone and the Aging Process

Many people assume aging is an unavoidable decline, yet for many men the changes they notice over time often begin with a gradual loss of testosterone. When testosterone starts to drop, it can influence energy, mood, physical strength, and overall well being. The good news is that these changes can be understood and supported through thoughtful hormone evaluation and, when appropriate, testosterone replacement therapy.

Over the years, both men and women have been led to believe that they are powerless against the symptoms that slowly chip away at their vitality. This belief can leave people feeling stuck or unsure of what to do next. I remind my patients often that aging and testosterone deficiency are closely connected, and there is much we can uncover by looking deeper into hormone health rather than accepting these changes as inevitable.

One pattern I see frequently is men being told they do not have low testosterone, even though they never received complete testing that includes both total and free testosterone. Without proper evaluation, important clues can be overlooked and symptoms may be dismissed. Since testosterone deficiency syndrome and age related changes commonly overlap, accurate testing is essential. If you have been told your levels are normal but still do not feel like yourself, seeking another opinion can be valuable.

What Low Testosterone Can Feel Like

As we look more closely at hormone health, it becomes clear that low testosterone shows up differently for each person. Still, there are common symptoms that tend to stand out:

• Fatigue and reduced energy:
  Low testosterone can contribute to persistent tiredness, lower motivation, and a general lack of energy. Men often notice they feel exhausted even after adequate rest or that physical activity becomes more challenging.

• Decreased sex drive and erectile changes:
  Testosterone plays an important role in libido and sexual function. Low levels may lead to decreased desire or difficulty achieving or maintaining an erection. It is important to note that testosterone is not the only cause of erectile dysfunction, but it can be a significant contributor.

• Loss of muscle mass and strength:
  Because testosterone supports muscle growth and maintenance, lower levels may make it harder to build or sustain muscle, even with regular exercise or physical activity.

• Increased body fat, particularly around the abdomen:
  Low testosterone often contributes to increased abdominal fat, creating a more apple shaped appearance. This type of fat is linked to health risks, including a higher chance of cardiovascular disease.

• Mood changes:
  Low testosterone can influence mood and behavior. Irritability, mood swings, depression, or reduced motivation may appear and can affect both daily life and relationships.

• Decreased bone density:
  Testosterone plays a role in bone strength. Lower levels can reduce bone density, which increases the risk of osteoporosis and fractures.

• Hair loss or thinning:
  Since testosterone affects hair production, lower levels may lead to thinning or increased shedding, particularly on the scalp.

• Changes in cognitive function:
  Some studies suggest a connection between low testosterone and cognitive shifts. Men may experience challenges with concentration, memory, or mental clarity.

• Sleep disturbances:
  Low testosterone can affect sleep regulation. Some men may have difficulty falling asleep, staying asleep, or may feel unusually tired during the day.

It is important to remember that having one or more of these symptoms does not automatically mean testosterone is low. Many factors can play a role, which is why proper testing and evaluation are essential.

What Your Lab Results Mean

Symptoms are only one part of the picture. Laboratory values help clarify what is happening on a deeper level. In men, testosterone deficiency syndrome may be indicated when:

• Total testosterone is below 800 ng per dL

• Free testosterone is below 150 pg per mL

These numbers, combined with the symptoms you are experiencing, help guide an accurate diagnosis.

At Mindful Medicine we provide comprehensive hormone testing that includes total testosterone, free testosterone, and additional markers that help us understand the larger hormonal landscape. Many patients find that this information offers clarity and a sense of direction, especially when they have felt unsure about their symptoms for a long time.

Additional Hormones That Provide Important Clues

Sometimes the reason for low testosterone becomes clearer when we evaluate related hormones. A few markers I often check include:

Luteinizing hormone (LH)
When LH is low, it may suggest pituitary insufficiency, meaning the pituitary gland is not signaling the testes effectively. When LH is above eight, it may indicate testicular failure. Both situations can be supported with appropriate care, including testosterone replacement therapy when indicated.

Estrone
Estrone levels above 30 pg per mL can point to elevated estrogen activity. Higher estrone levels can bind to testosterone, reducing the amount available for the body to use effectively.

Dihydrotestosterone (DHT)
DHT is a natural byproduct of testosterone. A DHT level below 25 can help confirm low free testosterone and reinforce the other findings.

Looking at these markers together helps us understand the root cause of your symptoms rather than simply addressing them on the surface.

When It Makes Sense to Look Deeper

If these symptoms feel familiar, it may be time to explore your hormone health more closely. At Mindful Medicine we offer supportive testing and step by step guidance so you can better understand what your body needs.

Wishing you love, light, and continued healing,
Dr. Hopkins